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Cancer Rehab Plus program combines exercise, therapy, and wellness support services

woman with cancer in nature while breathing fresh air, concept of a woman fighting cancer, woman with pink scarf relaxed.

The O’Neal Comprehensive Cancer Center at UAB’s Cancer Rehab Plus program anticipates and responds to patient needs at every stage of the cancer journey. It’s an approach to cancer rehabilitation that recognizes the complex challenges of cancer and how needs vary from person to person. The program is designed to help patients meet their health goals and make positive changes at every step of their journey – not just during setbacks.

With many physical injuries, damage is limited to certain parts of the body, and recovery times and rehabilitation are often predictable. But cancer tends to be unpredictable, and it can involve the entire body and the mind. Patients may need support during the ups as well as the downs.

Led by specialists

Cancer Rehab Plus is part of our wide range of supportive care services available to all patients being treated for cancer. It is led by three UAB specialists:

  1. Physical Medicine and Rehabilitation physician Danielle Powell, M.D., who leads rehabilitation care by evaluating any loss of function and uses a variety of treatments to ease the burden of any impairments
  2. Physical Therapist Elizabeth Bohorfoush, DPT, who provides manual therapies to help reduce pain and restore function
  3. Clinical Exercise Physiologist Sara Mansfield, CEP, NBC-HWC, who makes exercise and movement recommendations based on each patient’s diagnosis, treatment history, and lifestyle, to help them regain strength, function, and endurance

“Research has shown that avoiding inactivity is an important part of the treatment experience,” Mansfield says. “By staying more active, patients can slow their loss of functional ability, manage fatigue, and build resilience. Cancer rehab is evolving much like cardiac rehab, in that it provides guidance and support during this transitional time.”

Before, during, and after treatment

Mansfield says her role has been compared to a medical personal trainer for patients with cancer. She works with them to identify realistic exercise strategies for each phase of their cancer journey. Before treatment, resistance training builds strength that can help patients better tolerate treatment and maintain physical function. During treatment, light but regular movement can help with circulation, enhance their mood, and improve their response to treatment. After treatment, exercise can help patients regain control, energy, a sense of normalcy, and general well-being.

However, some patients may find it difficult to embrace structured or measured exercise, because they are so overwhelmed by their diagnosis and treatment.

“We start where the patient is currently in terms of ability and build on that baseline,” Mansfield says. “Starting slow and careful pacing is the safest and most effective formula for success, no matter what the goal. This isn’t about working out hard or overreaching – it’s about finding ways to take care of oneself.”

Wellness coaching

Most people understand the benefits of exercise, but they may avoid it during tough times. As a National Board-Certified Health and Wellness Coach, Mansfield works with patients to overcome resistance by helping them connect with their personal goals. Through a series of assessments and regular check-ins, she becomes an ongoing resource for patients during treatment and into survivorship.

“Simply telling people what to do doesn’t usually work,” Mansfield says. “Sharing knowledge and partnering with patients in developing an individualized plan for well-being can result in more engagement and enjoyment. Connecting behaviors to personal values and identifying barriers makes change more meaningful.”

Qualifying conditions

The Cancer Rehab Plus program can benefit patients with one or more of the following symptoms and concerns:

  • Major decrease in activity level
  • Tiredness/fatigue
  • Muscle weakness, stiffness, cramps, and/or spasms (myopathy)
  • Loss of balance, coordination, or both
  • High risk of falling
  • Loss of mobility, or the need for a cane, crutches, etc. to walk
  • Cancer that has spread (metastasized) to the bones
  • Loss of blood supply to the bones (avascular necrosis)
  • Conditions related to bone loss and reduced bone density, such as osteoporosis and osteopenia (whether they existed before or began after cancer treatment)
  • Ongoing weakness, numbness, or pain from nerve damage, usually in the hands and feet (peripheral neuropathy)
  • Scarring or thickened scar tissue (fibrosis) that affects movement and range of motion
  • Risk of lymphedema (a buildup of fluid in soft body tissue)
  • Weight gain due to hormone therapy
  • Needing to get stronger before having cancer surgery or starting cancer treatment, through a process known as prehabilitation

The Cancer Rehab Plus program is closely connected to other UAB Medicine resources and therefore can also help patients who need rehab for a physical injury, psychological counseling, or UAB Arts in Medicine services. Patients can sign themselves up for the program or request a referral from their oncologist or supportive care provider. Online virtual coaching is available.

“When you get actively involved in your own cancer rehabilitation, you aren’t just waiting on that next scan or bloodwork, and you generate motivation to keep looking ahead,” Mansfield says.

To learn more about the Cancer Rehab Plus program or to sign up, please call the Supportive Care Clinic at 205-801-8624.

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